Archive Infection Control 2016

5 Tips for Better Instrument Decontamination

Removing variables and automating the process are the keys to better cleaning.

Peter Daigle

decontamination process WASHING MACHINE Investing in automation helps standardize the decontamination process.

You know the drill: If an instrument isn't properly cleaned, it can't be properly sterilized. But the problem with the decontamination process is that each instrument might require a different set of cleaning instructions, and even the cleaning agents themselves can have considerable variations. When you add in the need to scrub tiny nooks and crannies on complex tools, it can make the task seem downright impossible. Focusing on the following factors can help standardize the process, make cleaning easier for your reprocessing techs and help reduce the risk of human error.

1. Point-of-use cleaning
Decontamination should always start at the point of use. At our hospital, after the physician is finished using a surgical instrument, it gets handed off to a nurse or tech responsible for pre-cleaning. Surgical instruments are wiped down to remove gross soil and then sprayed with an enzymatic cleaner.

Some facilities just rinse instruments in water or throw a wet towel on top and consider this first step satisfied. However, enzymatic sprays specifically designed for this task boost your decontamination process, because the solutions start removing bioburden as soon as they contact the instrument, which makes cleaning it even easier for techs down the line. Some sprays can even keep instruments moist for up to 72 hours, a benefit that we rely on at our facility since some of our off-campus clinics send their instruments to our central sterile department once a day.

Make sure the enzymatic spray you use is non-aerosol, which lets your staffers safely spray instruments immediately after use in the OR, even if a patient is still in the room.

2. The right cleaning agent
After used instruments are pre-cleaned, they are brought to the decontamination area in a closed container or cart. This starts our assembly line process to get the instruments ready for sterilization.

We start by placing the instruments into mesh baskets where we rinse off the enzymatic pre-cleaning solution. This step is crucial — we use one type of enzymatic cleaner for the point-of-use cleaning and different agents for the pre-soaking and washing steps in the decontamination area. You don't want the chemistries of the different enzymatic solutions to mix or dilute the next step's agent, which could compromise the decontamination process or leave a chemical residue behind.

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